Adult Basketball Team Roster
All information must be neatly printed or types. Please read roster carefully.
Your signature is acknowledgement and agreement of the waiver below.
Team: _____________________________________________ Manager: _________________________________________________
Cell Phone: ___________________________________ Email: _________________________________________________________
Mailing Address: ______________________________________ City: ______________________________ Zip: _________________
League Classification
(circle one)
C
D
D-2
Special Notes:
A minimum of (5) residents or (5) business sponsor employees must be on registration form and roster at time of registration to qualify for priority registration.
All residents must be listed on the registration form and must have their Beverly Hills address filled in on the roster below at the time of registration to receive resident rate.
All Beverly Hills business sponsor employees must be listed on the registration form and listed on the roster below at the time of registration to receive resident rate.
Player’s Name
HT
WT
Age
Address (City/Zip)
Cell Phone
Res/Bus
(x)
Signature
1
2
3
4
5
6
7
8
9
10
11
12
I acknowledge use of this sport facility requires courtesy towards its residential neighbors and I will refrain from littering and excessive noise and abide by street parking restrictions. As participants in the
Beverly Hills Adult Sports Leagues, we hereby acknowledge that our signature releases and discharges the City of Beverly Hills and all of its officers, agents, and employees from any and all liability for
claims, injuries, or damage to person or property. As a team representative, I hereby certify that all of the above information is correct and in no way falsified.
Signature of Manager:_____________________________________________________________________________ Date: _______________________________
Beverly Hills Community Services Department